My apolo­gies for not writ­ing in a few days…the Glob­al Agen­da Sum­mit in Dubai has required all my atten­tion — I will sum­ma­rize the great expe­ri­ence when I land back in San Fran­cis­co tomor­row night.

The con­cepts of night and day do become chal­leng­ing when work­ing for a few days in a place with a 12-hour time dif­fer­ence with one’s home base. Sleep is indeed very impor­tant to main­tain top cog­ni­tive shape…which leads me to a fas­ci­nat­ing news announce­ment:

- “help­ing con­sumers get a good night’s sleep has become a pri­or­i­ty for most of the top-tier U.S. health insur­ance com­pa­nies, includ­ing Well­Point, Aet­na, Cigna, Kaiser Per­ma­nente and sev­er­al Blue Cross plans. Their new pro­grams don’t involve sleep­ing pills. Instead, insur­ers are advo­cat­ing the use of cog­ni­tive behav­ior ther­a­py. Tra­di­tion­al­ly, the ther­a­py has been done large­ly through face-to-face ses­sions, but many of the pro­grams are now avail­able online.”

- “And use of sleep­ing pills has sky­rock­et­ed. A study this year in the jour­nal Health Affairs found a 50% jump in sleep­ing pill use — from 5,445 peo­ple per 100,000 in 1998 to 8,194 per 100,000 peo­ple in 2006. Though one ver­sion of Ambi­en, a pop­u­lar sleep aid, is now avail­able as a low­er-cost gener­ic cost­ing about 50 cents per pill, new­er drugs such as Roz­erem and Lunes­ta cost about $4 and $5 per pill, respec­tive­ly, or a min­i­mum of near­ly $1,500 per year for patients who take a sleep­ing pill every night. Online behav­ioral ther­a­py pro­grams cost less than $40 per user, and face-to-face coun­sel­ing can range from about $300 to $1,800, depend­ing on how many ses­sions a patient goes through and what lev­el of spe­cial­ist, from social work­er to psy­chi­a­trist, pro­vides the ther­a­py.”

- “Unlike sleep­ing pills, coun­sel­ing is usu­al­ly a one-time thing and costs do not con­tin­ue year to year.”

- In short, here we have a num­ber of major soci­etal prob­lems (anx­i­ety, depres­sion…) that affect peo­ple of all ages, and an inter­ven­tion that teach­es peo­ple cog­ni­tive skills to be able to man­age those relat­ed chal­lenges bet­ter. Talk about “teach­ing how to fish” vs. sim­ply hand­ing out fish (which we could argue is what anti­de­pres­sant med­ica­tions do).

- Why don’t more peo­ple ben­e­fit today from that approach? A major prob­lem, in my view, is the lack of a scal­able dis­tri­b­u­tion mod­el. Mean­ing, using the tra­di­tion­al face-to-face approach, one needs to cre­ate, train, cer­ti­fy, ensure qual­i­ty of, a very large net­work of prac­ti­tion­ers.

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